“That thing inside you” I was stopped by a supermarket checkout lady the other day, who exclaimed in a show-stopping voice: “Its Anne Diamond, isn’t it? Aren’t you looking well! Have you still got that thing inside you?” Looking well, is of course a euphemism for “haven’t you lost a lot of weight?” but I don’t mind. Since my weight has become such a public issue, it’s rather encouraging to hear something so positive! And the “thing” inside me to which she referred? I’m sure, to those around me, it conjured up images of those women throughout history who deliberately ingested parasitic worms in order to stay slim. Or the lady in a recent cartoon who was pictured in her doctor’s surgery asking for her gastric balloon to be inflated with helium in order to lose weight very quickly! “That thing” is of course, the gastric band I so famously had inserted nearly four years ago, and which still makes me a popular interviewee when the whole subject of obesity surgery makes headlines – which is almost every week nowadays. There’s no doubt, gastric bands and bypasses are huge news at the moment. Private operations are on the up, and within the NHS, the number of surgeries for obese people has soared In 1998-99 there were a total of 196 such operations rising to 2,695 in 2007-8 then leaping to 4,221 in 2008-9 Last year there were 909 in London , with 584 in Yorkshire and Humberside and 550 in the East Midlands 550. It’s easy to get over excited about the amazing success story of obesity surgery in the UK and elsewhere in the world. As recommended by NICE, gastric banding and gastric bypass procedures are the most successful, efficient and cost effective treatment for severe obesity Almost in a stroke, the operation can do away with type 2 diabetes, and in some cases, insulin dependent diabetes too. Now we hear that children as young as 14 are having the operations on the NHS, which is apparently relaxing its rules on the matter – in fact, I’ve been asked to make a film for prime time TV on that very subject, interviewing kids who have already had their lives “saved” by the procedure. So what’s the downside? I suppose we just don’t want to become the sort of society that needs to depend on surgery to stay slim and fit. Which is why I was excited by a new buzzphrase. You may have already heard it if you work in the “corporate” end of medicine. It’s called “mass localism” – and according to some experts, it could be the answer to beating obesity. Basically it means that communities might be better at solving some of society’s biggest problems than central government, or even public medicine. What’s more, according to NESTA , the National Endowment for Science, Technology and the Arts, it could save the NHS £210 million a year on a very modest investment (less than £3 million) Why? Because we ordinary men and women prefer “joining in “ than being “preached at “, and logically, what’s going to enthuse and motivate people in depressed inner cities in Scotland might be very different from what’s going to change people’s lives in poverty-stricken London commuter belt housing estates. It rings true to me. For instance, I find the government’s Change4Life campaign a bit preachey, patronising and simplistic. But show me a local initiative like a Shop-and-Bike scheme or a community based project where I can go kayaking or flying kites with the family at weekends, and I’d be much more likely to get off my backside and get active. Health treatments are more effective when patients have personal relationships to support them through recovery; education is more effective when parents are involved; policing works better when the community supports it. That’s what people have told NESTA. They want “people powered public services”. We’re all in this together. The obesity epidemic we’ve been predicting is now here. The latest cost estimate is £4.2 billion per year. Currently, 8 per cent of young males and 10 per cent of young women are obese and the government has projected this to rise to an average of 15 per cent by 2025. Change4Life is supporting only a few community projects. NESTA reckons putting more of the effort into far more community-led projects could bring in a far higher return in terms of human lives transformed and saved. I reckon we should listen to them
